Exercises in Differential Diagnosis (Classic Reprint)
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Stand: | 2015-08-04 03:50:33 |
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Produktbeschreibung
Excerpt from Exercises in Differential Diagnosis An old washerwoman, sixty-eight years old, generally healthy, has been feeling poorly for a month and losing appetite. A week ago began to have pain in abdomen; at first all over, but later settling in the lower left corner. Hurts her especially if she tries to walk, but has not been severe enough to keep her awake until last night, when it became severe. She has always been constipated, and the bowels have not moved for two days. No vomiting, but has taken hardly anything to eat for two days. Examination: Emaciated, sallow, tongue coated, breath offensive. Temporal arteries stiff and tortuous. Heart dulness reaches to the right border of the sternum and as high as the second rib. Apex just below the fifth rib in the nipple line. At the ensiform cartilage, a short murmur replacing the second heart sound and heard less distinctly elsewhere. First sound at the apex very short; heart´s action somewhat irregular. Few moist rales at bases of both lungs, with slight dulness and diminished breathing over lower half of left back. Voice sounds normal. Tactile fremitus slightly diminished. Abdomen slightly distended; tender in left iliac fossa, where a deep resistance is felt, but no tumor to be outlined. Liver dulness from seventh rib to rib margin. Right kidney palpable. Urine normal color; acid, 1017; trace of albumen. Sediment: considerable pus, squamous, spindle and neck of bladder cells. Calcic oxalate crystals and mucus. Knee jerks not obtained. Temperature, 102 at entrance; normal next day. Pulse, 100. An enema brought away a small movement, very dark in color. Diagnosis? Prognosis? Treatment? What probably explains the area of liver dulness? How is the temperature explained? What is the significance of the calcic oxalate? About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.
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